   
Lack Of Insurance Tied To Higher Death RatePeople who have no health insurance are sick more often, are avoidably hospitalized more often, and die sooner than those with coverage. So says a report, resulting from a literature search, by the American College of Physicians - American Society of Internal Medicine (ACP-ASIM). Documenting what many had suspected, that being uninsured is unhealthy and life-threatening, the study found that the uninsured receive less timely care than those with coverage and that this lack of access affects health adversely. The uninsured are hospitalized more often for situations that are avoidable, such as 2.8 times more hospitalization for diabetes and 2.4 times more for hypertension. When hospitalized, the uninsured are 3.2 times more likely to die than those with insurance. The biggest problem is the lack of knowledge among Americans about the consequences of being uninsured.
Drug Blocks Most Heart Attacks During SurgeryA beta-blocker commonly used to lower high blood pressure helps people at risk undergo surgery without having a heart attack. The remarkable finding of a study in the New England Journal of Medicine found that deaths were reduced by 90 percent. When 112 high risk heart patients underwent surgery, only 3.4 percent of those pretreated with bisoprolol, sold as Zebeta or Ziac, suffered a heart attack. This compared to 34 percent who did not receive the medication. Ultrasound tests done before surgery determined that all 112 were at high risk of heart problems. The bisoprolol was begun at least one week before surgery and continued until 30 days afterward. Then surgery was performed to repair an artery in the groin or abdomen. The benefits were so evident that the study was stopped early so that all the patients could receive bisoprolol. The researchers, led by Don Poldermans of the Erasmus Medical Center in the Netherlands, conclude that beta-blockers should be routinely given to high-risk patients before surgery. The study also concludes by extension that beta-blockers should be given pre-surgery to any patients who has cardiac risk factors such as previous heart attacks, diabetes, heart failure, angina or poor exercise tolerance. Similarly, beta-blockers should be given before surgery to all patients who are over 70 years of age.
New 48 Hour Insulin Being DevelopedFlamel Technologies and Novo Nordisk are entering into an agreement to develop and market a new long-acting, 48 hour insulin, called Basulin. Novo Nordisk acquires exclusive worldwide development and marketing rights. In return, Flamel Technologies receives up-front licensing fees of $5 million and a potential $37 million in milestone payments and royalties on future product sales. Basulin, created from insulin linked to tiny particles of an amphiphilic block copolyaminoacid, has a flatter 48 hour action time, compared to the 20 to 24 hour action of NPH and Lente insulins. This consistent delivery with Basulin has the potential to improve control in people with diabetes. Phase I clinical trials are now underway in Britain and are expected to be completed early in 2000.
Femprox Improves Female Sexual ArousalSimilar to men, sexual arousal in women is often enhanced when blood flow to the sex organs is increased. Now NexMed, Inc. has developed and tested a cream, called Femprox, that has demonstrated a positive effect on increasing blood flow to the clitoris and labia in trial participants. Femprox cream, with active ingredient alprostadil (prostaglandin E1) and NexMed's proprietary NexACT transdermal drug delivery system, demonstrated a positive effect on increasing blood flow to the clitoris and labia in 18 women between 18 and 61 years old. The study, conducted by Dr. Edgardo F. Becher as principal investigator was designed to test Femprox for treating Female Sexual Arousal Disorder (FSAD). The study measured blood flow through the blood vessels in the clitoris using duplex ultrasonography. Thirteen of the participants experienced labial and clitoral engorgement and a warm sensation. The only side effects were local and minimal. Approximately 47 million American women, including 75% post-menopausal, are estimated to suffer from FSAD, with symptoms that include the inability to experience sexual arousal or orgasm. The complicated causes of FSAD may include depression, stress and fatigue, but many patients experience problems with natural lubrication. This may result from poor blood flow in the genital area, often caused by menopause, diabetes and hysterectomies. The Femprox cream may improve the blood flow to the genital area and restore the natural blood engorgement and lubricating secretions during sexual stimulation. In August 1999 in FDA Phase I clinical trial results, Femprox cream showed statistically significant (p<.05) improvements in arousal, lubrication, engorgement, pleasure, and relaxation. Phase II clinical trials are expected to begin soon.
Depression May Cause Diabetic Heart DiseaseResearchers led by Dr. Trevor J. Orchard at the University of Pittsburgh Medical Center in Pennsylvania have determined that feelings of depression may be a precursor to developing heart disease in Type 1 diabetes. The study, published in Atherosclerosis 2000, examined 658 people with Type 1 diabetes initially and then every 2 years for 6 years. From the information collected, the researchers determined the risk factors for heart disease and lower leg blood vessel disease. The researchers found both expected and unexpected results. Two known risk factors for heart disease, high blood pressure and low levels of HDL (or ``good'') cholesterol, are associated with increased heart risk. But, interestingly, so was depression. For blood vessel disease in the legs, however, the risk factors were smoking, high levels of LDL (''bad'') cholesterol and high blood sugar. Surprisingly, high blood sugar did not increase the risk of heart disease in this study. But there are other good reasons to keep the blood sugar normal, such as avoiding other complications. Unfortunately, the study does not prove that treating depression will reduce the risk of heart disease, but seeking treatment for depression appears to be a good idea.
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